Título

EFFECTS OF POSTERIOR SUBTENON INJECTION OF TRIAMCINOLONE IN PATIENTS WITH CYSTOID MACULAR EDEMA

Introdução / Purpose

To evaluate the effects of posterior subtenon injection of triamcinolone in patients with cystoid macular edema.

Material e Método / Methods

A prospective study of three patients who underwent posterior subtenon (ST) injection of triamcinolone acetonide for treatment of cystoid macular edema (CME) from October to December 2017. All applications were made by single injection of 1 ml (40 mg) triamcinolone, under topical anesthesia in the upper temporal quadrant. The patients were evaluated before and after the injection by means of measurements of visual acuity (VA), tonometry and optical coherence tomography (OCT).

Resultados / Results

The patients were between 60 and 76 years old. Two patients had Diabetes Mellitus. All cases were unilateral and pseudophakic of the eye with macular edema, besides retinal detachment in two cases. In one case, whose edema is chronic, intravitreal treatment had already been performed, without success. VA prior to the ST injection of triamcinolone ranged from 20/80 to 20/400 and after ranged from partial 20/40 to 20/70. Analyzing the OCT, macular thickness prior to injection varied between 322 and 534 μm and after between 260 and 410 μm. The OCT was between 15 and 86 days after the procedure. There was no notable increase in intraocular pressure (IOP) after treatment. Macular thickness of the eyes treated with one injection was significantly reduced.

Discussão e Conclusões / Discussion

Periocular corticosteroids have been shown to be effective for CME refractory to topical treatments.1 However, its use is not risk-free, elevation of IOP is a complication. Luo et al. demonstrated that the increase in IOP was 21.5% after intravitreal injection and 3.0% after ST injection.2 In this present study, there was no increase in IOP. Furthermore, ST injection offers less complications for patients. In conclusion, intravitreal therapy still remains the gold standard for treatment of CME, but periocular therapy should not be forgotten, because it is safe and economically viable.

Palavras Chave

subtenon injection; triamcinolone; macular edema